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장석흔,김종기,심봉석,조수연,구혜수 梨花女子大學校 醫科大學 醫科學硏究所 1994 EMJ (Ewha medical journal) Vol.17 No.1
Malignant fibrous histiocytoma(MFH) is the most common soft tissue sarcoma of late adultlife, majority of cases occuring in persons between ages of 50 and 70. It occurs most frequently on the lower extremity followed by upper extremity and retroperitoneum. Primary involvement of the kidney is quite rare, with only 19 cases reported in the literature. We report a case of 74-year-old woman with histologically proven MFH of the right kidney.
방광의 원발성 인환세포선암 2례 : Report of Two Cases
장석흔,전준영,심봉석,권성원 梨花女子大學校 醫科大學 醫科學硏究所 1993 EMJ (Ewha medical journal) Vol.16 No.1
Primary signet ring cell adenocarcinoma of the bladder accounts for less than 1 per centof all primary bladder neoplasm. 19 cases have been reported in the literature. This tumor is insidious because of its subepithelial infiltrative nature, which makes diagnosis possible only late in the course of the disease. Survival is poor ; greater 50 per cent of the patients are dead within a year after diagnosis.Radical surgery offers the only hope of palliation ; irradiation and chemotherapy have notbeen effective. We are reporting two cases of primary signet ring cell adenocarcinoma of the bladder treatedwith radical cystectomy with pathological findings and review of the literature.
Marshall-Marchetti-Krantz 수술법을 이용한 긴장성 요실금의 치험
장석흔,심봉석,권성원 梨花女子大學校 醫科大學 醫科學硏究所 1995 EMJ (Ewha medical journal) Vol.18 No.4
목적 : 긴장성 요실금의 치료 방법인 Marshall-Marchetti-Krantz 술식의 치료 결과를 알기 위해 본 연구를 실시하였다. 방법 : 저자들은 1990년 l월부터 1993년 12월까지 만 4년간본원에서 긴장성 요실금으로 입원하여 Marshall-Mar-chetti-Krantz 술식을 적용한 83례 증 1년 이상 추적관찰를 한 66례를 분석하였다. 결 과 : 1) 환자의 연령 분포는 33세에서 53세이었으며(평균44.9세), 평균 출산 횟수는 3.1회였고 4회 이상의 다만부는 29명 (43.9%)이었다. 2)요실금 증상위 정도는 Grade I이 22례(33.3%),Grade Ⅱ가 40례(42.4%), Grade Ⅲ가 4례(6.1%)로 전체적으로 Grade Ⅱ가 가장 많았다. 3) Chain을 이용한 방광요도조영상 나타난 후부요도와방광저부가 이루는 각(PUV angle)은 평균 154.0˚(134~179˚)이었고, 요도경사각(Urethral inclination)은 평균 29.3˚(14~50˚)이었다. 4) 수술시간은 36분에서 72분 사이로 평균 45.2분이였고, 술후 요토카테터 유치기간은 평균 5.0일(4일~8일)이였으며, 수술 후 재원기간은 평균 8.3일(7일~15일)이었다. 5) 수술 후 합병증으로 요정제가 6례(9.0%)가 나타난이외에 다른 합병증은 없었으며. 모두 간헐적 도뇨법 3~7일 시행후 해결되었다. 6) 수술 6개월 후 추적관찰한 결과에서 완치를 보인 경우가 49례, 호전을 보인 경우가 12례이었으며 , 2례에서는술후 3개월째에 재발하였고, 3례에서는 술후 12개월째 요실금이 재발하여 수술 성공율은 92.4%로 나타났다. 결론 : 긴장성 요설금 환자에서 Marshall-Marchetti-Krantz 수술 방법은 안전하게 시술되어질 수 있으며, 앞으로 타 술식과의 비교관찰이 필요하리라 사료된다. Objectives : The purpose of this study is to investigate the clinical result of Marshall-Mar-chetti-Krantz operation, one of the treatment methods for stress urinary ncontinence. Methods : Authors have analyzed the 66 cases out of 83 stress urinary incontinence patientsin whom Marshall-Marchetti-Krantz operation and 1 year follow-up was performed at UrologyDepartment of Ewha Womans University Hospital from January 1990 to December 1993. Results : The results were as fo11ows : 1) The patients' age distribution was from 33 to 53 years old (mean age 44.9 years). The average number of deliveries was 3.1 and 29 patients were multipara with more than 4 deliveries. 2) As compared with urinary incontinence grade, Grade I was seen in 22 cases (43.9%),Grade Ⅱ in 40 rases (42.4%) and Grade Ⅲ in 4 cases (6.1%). Overall Grade Ⅱ was most frequent. 3) PUV angle between posterior urethra and bladder base seen by chain cystourethrographywas 154.0˚(134-179˚) in average and urethral inclination was 23.9˚(14-50˚)in average. 4) The operation took between 36 to 72 minutes with mean 45.2 minutes. Urethral catheter was placed after the operation for mean 5.0 days (4-8 days) ana hospitalization days weremean 8.3 days (7- 15 days). 5) 6 cases (9%) of urinary retention was the only postoperative complication and all of themwere resolved 3-7 days after intermittent catheterization. 6) In the fi11ow-up after 6 months, recurrence was seen on the third month after the operationin 2 cases and on the 12th month in 3 cases which resulted in 92.4% of operation success rate. Conclusion : Marshall-Marchetti-Krantz method can safely be performed in patients withstress urinary incontinence and further comparative study with otter operation method be needed.